Provider Demographics
NPI:1124884465
Name:AL MAAZ, ADEL (BDS, MS)
Entity type:Individual
Prefix:DR
First Name:ADEL
Middle Name:
Last Name:AL MAAZ
Suffix:
Gender:M
Credentials:BDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4553 VALERIO CRES.
Mailing Address - Street 2:
Mailing Address - City:LASALLE
Mailing Address - State:ONT.
Mailing Address - Zip Code:N9H 0N2
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4553 VALERIO CRES.
Practice Address - Street 2:
Practice Address - City:LASALLE
Practice Address - State:ONT.
Practice Address - Zip Code:N9H 0N2
Practice Address - Country:CA
Practice Address - Phone:519-971-1653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016019631223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics